title: A tale of three diseases of the bone.
abstract: Paget's disease is a relatively rare disorder of the bone with only a few reports and case series observations from India. Hypocalcaemia is rare in Paget's disease, usually occurring as a consequence of therapy with bisphosphonates. We report a 65-year-old woman with Paget's disease who had hypocalcaemia secondary to vitamin D deficiency. On further evaluation, she also had severe osteoporosis. How vitamin D deficiency affects the diagnosis and monitoring of Paget's disease and the relationship between the three diseases are discussed. This case illustrates an interesting situation with abnormal bone turnover, remodelling and mineralisation in the form of Paget's disease with osteomalacia and osteoporosis.
authors.affiliation: Associates in Clinical Endocrinology, Education and Research, 7/12, 15th Cross Street, Sastri Nagar, Adyar, Chennai 600020, India. subramanian.kannan@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Kannan
authors.forename: S
authors.initials: S
authors.lastname: Mahadevan
authors.forename: A
authors.initials: A
authors.lastname: Sathya
authors.forename: U
authors.initials: U
authors.lastname: Sriram
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology; D002119:Calcium Carbonate / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000150:complications / Q000175:diagnosis* / Q000209:etiology; D007093:Imidazoles / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000473:pathology; D010001:Osteitis Deformans / Q000150:complications / Q000175:diagnosis*; D010018:Osteomalacia / Q000175:diagnosis / Q000473:pathology; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis*; D000077211:Zoledronic Acid
chemical_list: D004164:Diphosphonates; D007093:Imidazoles; D002762:Cholecalciferol; D000077211:Zoledronic Acid; D002119:Calcium Carbonate